Effect of Preoperative Multimodal Lifestyle Interventions on Functional Capacity in Colorectal Cancer Patients and the Importance of Personalization

In recent years the preoperative phase of a patient undergoing colorectal cancer surgery is increasingly studied, due to the increasing evidence of “better in, better out” prehabilitation programs, as a means to improve patient outcomes in recovery after surgery. Multimodal programs seem to be of additional benefit to these patient outcomes. Questions remain however which interventions are best suited for improving patient outcomes and to what extent these are tailored to personal capabilities and personal preferences. This systematic literature review analysed, after a thorough search through four different databases, six studies of which four randomized clinical trials. Results showed that most patients benefited from participating in a multimodal prehabilitation program, increasing their functional capacities before and after surgery. Yet frail elderly seemed to benefit less from a prehabilitation program while inactive patients showed greater improvements compared to the more active patients. Furthermore, adherence was higher in the prehabilitation program compared to rehabilitation and personalization of the program appeared to improve adherence. It seems to be of importance to identify which colorectal cancer patients benefit most from a prehabilitation program and how personalization can further increase the benefits of prehabilitation.